UM Administration Coordinator

Become a part of our caring community and help us put health first

The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

• Responsible for intercepting inbound calls and assisting facilities/providers in scheduling and coordinating Peer to Peer discussions
• Managing Humana Medical Directors' calendars
• Monitoring and decisioning authorizations
• Responding to provider inquiries regarding existing authorizations, and providing timely updates as needed via fax or phone calls, ensuring compliance with organizational policies and applicable federal regulations.
• Maintaining high-quality standard and meeting monthly quality requirements
• Ability in maneuvering multiple systems simultaneously

• Communicate ideas and updates clearly to team members, actively listen to feedback and concerns, and facilitate open, honest dialogue.
• Collaborate and contribute effectively to team projects and goals, supporting colleagues and resolving issues that impact the team.
• Share knowledge, work effectively with cross-functional teams, and coordinate tasks and responsibilities among team members.

• 1 or more years’ experience working in an administrative support capacity in a healthcare setting
• Excellent verbal and written communication skills
• Demonstrated attention to detail
• Ability to navigate process flows and follow procedure documents
• Working knowledge of MS Office including Word, Excel, Teams, and Outlook in a Windows based environment and an ability to quickly learn new systems
• Must effectively manage personal responsibilities to ensure a professional work environment conducive to achieving performance goals

• Proficient utilizing electronic medical record and documentation programs
• Prior experience with CGX and Genesys
• Prior experience with post-acute authorizations
• Prior experience in a metric driven environment
• Prior experience in the healthcare industry
• Proficient and/or experience with medical terminology and/or ICD-10 codes
• Prior member service or customer service telephone experience desired
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

• Work hours are Monday-Friday 7am-7pm EST (Your 8-hour shift will fall within this timeframe)
• Overtime available based upon business needs
• Weekend and/or holiday coverage possible for this role

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

40

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$40,000 - $52,300 per year

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term…